Accepted at: Apr, 15, 2025 10:51 a.m.
Author: braviboron
Related Deck: 1675118865074
Accepted
Rationale for new note

I apologise for another annoying card. It's an important question that I find is useful for both exams and clinical decision making, but resources are hard to find.

We could split this up, but feel that it might be best addressed with one card like this? Welcome your thoughts.

Text
What are the most common bacterial pathogens causing neonatal sepsis?

Early onset (< 72 hours):
{{c1::GBS > E. coli}}

Late onset (> 72 hours) in term infants:
{{c1::E. coli > GBS}}

Late onset (> 72 hours) in pre-term infants:
{{c1::Coagulase negative staphylococci (e.g. Staph epidermidis)}}
Text
What are the most common <u>bacterial pathogens</u> causing <b>neonatal</b> <b>sepsis</b>?<br><br><div><b>Early onset (&lt;&nbsp;</b><b>72 hours)</b><b>:</b></div><div>{{c1::GBS &gt; E. coli}}</div><br><div><b>Late onset (&gt; 72 hours) in <u>term</u> infants:</b><br></div><div>{{c1::E. coli &gt; GBS}}</div><br><div><b>Late onset (&gt; 72 hours) in <u>pre-term</u> infants:</b><br></div><div>{{c1::Coagulase negative staphylococci (e.g. Staph epidermidis)}}</div>
Extra
This is based on UpToDate. Australian sources are less clear. See additional resources. 

Extra
This is based on UpToDate. Australian sources are less clear. See additional resources.&nbsp;<br><br><img src="87cec0c8d1d4fc25944466c31948caea.webp">
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Additional Resources
Term 'late onset sepsis' is not consistently defined; some resources define late as 48 hours, others 72 hours. Some sources do not differentiate between term and preterm neonates. 

Australian sources on neonatal sepsis (not differentiated into pre-term and term infants):
https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/sepsis-in-neonates#goto-sepsisfacts-and-causes says after 48 hours: '> 70 per cent due to coagulase-negative Staphylococcus and Staphylococcus aureus, 10-15 per cent due to Gram negatives.'  Updated 2017. Accessed March 2025. 
American sources:
Singh, M, Alsaleem, M & Gray, C P 2022, 'Neonatal Sepsis', StatPearls, viewed 10 January 2025, https://www.ncbi.nlm.nih.gov/books/NBK531478/
'Coagulase-negative staphylococcal species, especially Staphylococcus epidermis, are the leading cause, responsible for over 50% of LOS cases in industrialized countries.'
Additional Resources
Term 'late onset sepsis' is not consistently defined; some resources define late as 48 hours, others 72 hours. Some sources do not differentiate between term and preterm neonates.&nbsp;<br><br><b>Australian sources on neonatal sepsis (not differentiated into pre-term and term infants):</b><br><a href="https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/sepsis-in-neonates#goto-sepsisfacts-and-causes">https://www.safercare.vic.gov.au/best-practice-improvement/clinical-guidance/neonatal/sepsis-in-neonates#goto-sepsisfacts-and-causes</a>&nbsp;says after 48 hours: '&gt; 70 per cent due to coagulase-negative&nbsp;<em>Staphylococcus&nbsp;</em>and&nbsp;<em>Staphylococcus aureus,&nbsp;</em>10-15 per cent due to Gram negatives.'&nbsp; Updated 2017. Accessed March 2025.&nbsp;<br><div><b>American sources:</b></div><div>Singh, M, Alsaleem, M &amp; Gray, C P 2022, 'Neonatal Sepsis',&nbsp;<i>StatPearls</i>, viewed 10 January 2025,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/books/NBK531478/">https://www.ncbi.nlm.nih.gov/books/NBK531478/</a><br></div><div>'Coagulase-negative staphylococcal species, especially Staphylococcus epidermis, are the leading cause, responsible for over 50% of LOS cases in industrialized countries.'</div>
Source
Uptodate Neonatal bacterial sepsis: Clinical features and diagnosis in neonates born at or after 35 weeks gestation. Updated Nov 11, 2024. Accessed 15 April 2025. https://www.uptodate.com/contents/neonatal-bacterial-sepsis-clinical-features-and-diagnosis-in-neonates-born-at-or-after-35-weeks-gestation?search=Bacterial pathogens in neonatal sepsis and focal neonatal infections&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Source
Uptodate Neonatal bacterial sepsis: Clinical features and diagnosis in neonates born at or after 35 weeks gestation. Updated Nov 11, 2024. Accessed 15 April 2025.&nbsp;<a href="https://www.uptodate.com/contents/neonatal-bacterial-sepsis-clinical-features-and-diagnosis-in-neonates-born-at-or-after-35-weeks-gestation?search=Bacterial%20pathogens%20in%20neonatal%20sepsis%20and%20focal%20neonatal%20infections&amp;source=search_result&amp;selectedTitle=1%7E150&amp;usage_type=default&amp;display_rank=1">https://www.uptodate.com/contents/neonatal-bacterial-sepsis-clinical-features-and-diagnosis-in-neonates-born-at-or-after-35-weeks-gestation?search=Bacterial pathogens in neonatal sepsis and focal neonatal infections&amp;source=search_result&amp;selectedTitle=1~150&amp;usage_type=default&amp;display_rank=1</a>
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#Malleus_CM::#Subjects::Paediatrics::04_Emergency::Paediatric_Sepsis::02_Aetiology #Malleus_CM::#Subjects::Paediatrics::09_Neonatology::Paediatric_Sepsis::02_Aetiology #Malleus_CM::#Resources_by_Rotation::Emergency #Malleus_CM::#Resources_by_Rotation::Paediatrics